Another of the “debulking” surgeries that claim to greatly improve lymphedema. This procedure was named after Emmanuil Kondolean (1879- 1940). He was a Greek surgeon and a distinguished Professor of Surgical Pathology.

Made famous as Kondoleon's procedure, his technique included wide excision of the fascia and concomitant partial excision of the hypertrophic tissue. Such important personalities as Kondoleon set great examples in medical history and inspire future young generations of physicians. (1)

The procedure is actually still being used today, almost 100 hundred years after it invention.

Complications

The complications involving the other debulking surgeries applies to this one as well. In today’s world, a debulking surgery should only be used for the most extreme, potentially life threatening lymphedema swelling or for the terrible disfigurements of lymphatic filariasis, genital lymphedema or removal of massive localized lymphedema.

These complications include:

(1) extensive nerve damage
(2) swelling that will soon return
(3) the surgery exposes the lymphedema patient to the possibility of severe or life threatening surgery and
(4) there is often a serious need for further skin grafts. It is therefore absolutely inexcusable for any physician to recommend, suggest or perform the surgeries.
(5) any intrusive procedure exposes the lymphedema patient to dangerous, potentially life threatening infections.
(6) there is no guarantee that they procedure will make the patient less susceptible to cellulitis. It is interesting to me, that the leg I had the debulking on, is the limb that has had constant cellulitis. My right leg did not have any debulking surgery and thus far, no cellulitis either.

I had three debulking surgeries on my left leg in the early 1970’s. Each surgery took around nine hours and I was given 8 – 10 pints of blood per surgery. The procedures are brutal and in my opinion not worth the future damage they cause.

I have long been an outspoken opponent on the use of debulking surgeries for lymphedema patients. In my article Complications of Debulking Surgery, I shared my own experience with this proceure and the long term effects on my left leg.

Our era is characterized by the rapid improvements in treatment in all areas of medicine. But we should not forget those pioneers who, with their medical actions and inspiration, changed the course of their era and left their mark on medical history. One of those is the Greek surgeon Emmanuil Kondoleon (1879-1940). His brilliant scientific personality, numerous teaching activities, and his notable publications made him a distinguished Professor of Surgical Pathology. At the beginning of the 20th century, when very little was known about lymphedema and especially its treatment, EmmanuilKondoleon arrived on the scene with his own original technique that led the surgical treatment of lymphedema for more than 50 years. Made famous as Kondoleon's procedure, his technique included wide excision of the fascia and concomitant partial excision of the hypertrophic tissue. Such important personalities as Kondoleon set great examples in medical history and inspire future young generations of physicians.

Historical events and their in-depth analysis have much to teach us about medicine today. Moreover, the lives of those who have made their mark in medical history can be a source of inspiration to future generations of medical scientists. A case in point is the career of E. Kondoleon, originator of the surgical procedure that bears his name.

METHODS:
Retrieval in the archives of the “Areteion” and “Hippocration” hospitals, where E. Kondoleon had worked and passed away, together with information obtained from the Chair of History of Medicine of the University of Athens, as well as information taken from the Hellenic Surgical Society relative to his life and the motives which led him to the Kondoleonsurgical procedure namely: Wide excision of the fascia and concomitant partial excision of the hypertrophic tissue in the treatment of lymphoedema.

RESULTS:
The Kondoleon operative procedure was not a simple applicable idea of a surgical technique but the result of a long-term systematical study of the anatomy and pathophysiology of the lymphovascular system as well as the continuation of their experimental application. Thus in the beginning of our century, Kondoleon took the lead of carrying out his own technique on the human which for more than 50 years was the object of discussion and application in the treatment of lymphoedema.

CONCLUSIONS:
Although “the microworld” of the electronic microscope and the conventional microscope of surgery have illuminated many sections of pathophysiology and has led to newer evolutionary tactics (vascular anastomoses, transplantation of lymph-vessels) in the management of lymphoedema,

The Kondoleon operative procedure has given the necessary stimuli for these developments. As with other prominent, celebrated men in the history of investigation,Kondoleon had a dramatic end.